Geriatric radiotherapy in a war-torn country: Experience from Iraq

Cancer prevalence and geriatric patients (GP) are increasing and about half of the patients with cancer will be offered radiotherapy (RT). Addressing GP and their RT needs is an important issue in order to understand this heterogeneous group of patients. A descriptive cross-sectional study, using a convenience sample from Sulaimani city's inhabitants, aged 70-year and more, who were treated with RT at the only city's RT center, Zhianawa Cancer Center (ZCC), in 2015. 153 patients' charts were reviewed. GP represented 20% of the patients referred to ZCC. Male: Female ratio was 3:1. One third presented with distant metastases, and 46% were treated with curative intent versus 54% with palliative intent. 94% completed the planned sessions of the curative RT vs 90% of the palliative RT. 23% of GP who were referred for RT didn't receive it. 9% got interruptions during RT course. 10% of GP living >40 km away from the treatment center refused treatment. Mean time interval between the date of referral and the date of starting treatment in the palliative setting was 19 days. Only 41% of patients with curative setting had regular follow-up. Being the 1st study in this regard in a war-torn nation, Iraq, our results demonstrated that GP is a sizable group of ZCC patients and that RT is a valuable modality in GP cancer treatment. “Age per se” is not a factor to avoid this modality when there is an indication to use it. Longer distance to reach the center was a challenge in some of our GP. Due to inadequate number of RT machines, GP have to wait long time before getting their RT, even for palliative purposes. Further studies in this field are warranted.